Diurétiques en Milieu Hospitalier Entre Utilité et Iatrogénie : Cas du CHU de SETIF.

Abstract

Introduction: Diuretics are drugs commonly used in hospitals. They act mainly on the regulation of the natriuresis. Like any other drug, diuretics have side effects related to their mode of action. The aim of our study is to evaluate the link between furosemide (Lasilix®) and adverse events, also to investigate factors of iatrogenic over-risk. Patients and Methods: Our observational study exposed/unexposed was carried out on a sample of 108 patients hospitalized at the UHC of Setif (cardiology, nephrology and internal medicine departments) over a period of five months. The data was collected through the consultation of patients’ treatment sheets and their biochemical blood tests’ reports: urea, creatinine, Natremia and Potassemia. Results and Discussion: The studied population consists mainly of older subjects, the sex ratio is 1.08 and the administration of furosemide is most often performed at low dose. The patients included are practically all polypathological. The underlying pathologies most encountered in both groups (treated or not with furosemide) are heart disease and high blood pressure, the proportion of kidney disease is also not negligible. So the initial frequency of biological disturbances, considered as adverse events in the study, is already high. Furosemide decreases the occurrence of biological disturbances by 8.2% taking into account the age factor. This is due to the high frequency of this type of disorder in the studied population and their potential correction by furosemide. Which complicates the assertion of the link between this drug and the desired adverse effects. Age was detected as a confusing factor, unlike renal function and high blood pressure. A relationship between the administration of furosemide and dyskaliemia was observed. Conclusion: Iatrogenesis is not only related to the drug administered, but to a variety of factors, which must be controlled in order to judge the relationship between the drug and the adverse effects. The assumptions generated deserve to be verified in further studies. In order to reduce preventable adverse effects due to diuretics, related hospitalizations and thus improving the life-quality of patients to be treated.